Hepatitis E Virus (HEV) in Makkah, Saudi Arabia: A Population-Based Seroprevalence Study.

BACKGROUND: The Hepatitis E virus (HEV) is a common cause of viral hepatitis worldwide. Little is known about the seroprevalence of HEV in the general population of Saudi Arabia. METHODS: A community-based cross-sectional HEV seroprevalence study was conducted in Makkah, Saudi Arabia. Anti-HEV IgG antibodies were detected in sera using an in-house ELISA. The frequency of HEV sageerology and its correlation with demographic, and environmental factors were evaluated. RESULTS: Enrollment consisted of 1329 individuals, ages ranged from 8 to 88 years, the mean age was 30.17 years, the median age was 28yrs, and the male: female ratio was 1.15. The overall seroprevalence was 23.8% (316/1329). Males had significantly higher seroprevalence than females (66.1 vs. 33.9%; p < 0.001). Seroprevalence had significant correlations with age, occupation, and lack of regular water supply and housing conditions. CONCLUSIONS: This is the first HEV community-based seroprevalence study from Saudi Arabia. Results show that the HEV is endemic in Makkah and affects all age groups and occupations. HEV affects more males than females and those living in crowded accommodations without a regular supply of water. Further studies are required across all regions of Saudi Arabia to determine the country's seroprevalence of active or past infection using tests for HEV IgG, HEV IgM antibodies and/or HEV RNA and underlying determinants of transmission.

Enhancing the Oil Recovery from Naturally Fractured Reservoirs Using Viscoelastic Surfactant (VES) Flooding: A Field-Scale Simulation.

A viscoelastic surfactant (VES) has the combined properties of a surfactant and a polymer. Injection of VES fluids into naturally fractured reservoirs (NFRs) can control the mobility of the injected fluid and enhance the total oil recovery. This paper presents a field-scale simulation to evaluate the performance of a noble VES fluid in enhancing the oil recovery from a naturally fractured reservoir. In this work, the results of coreflooding, computerized tomography (CT)-scan, rheology, interfacial tension (IFT), and adsorption measurements were used to build and calibrate a lab-scale model. Thereafter, a chemical enhanced oil recovery (EOR) modeling simulator developed by a computer modeling group (CMG-STARS) was used to build a field-scale simulation. Real seismic data, permeability and porosity distributions, and operating conditions were utilized to develop and evaluate the simulation model. The results show that VES can outperform the surfactant-polymer (SP) flooding and waterflooding in NFRs; VES improved the oil recovery by 10% and reduced the water cut by 47%, at the same conditions. VES reduced the IFT by two orders of magnitude (100 times) compared to waterflooding. Also, VES altered the rock wettability to a more water-wet status, leading to reduce the relative permeability to water (K rw) by a factor of 10, on average. Finally, the simulation study indicated that applying waterflooding after VES flooding leads to a minor increase in the oil recovery. Overall, this study provides a detailed comparison between VES flooding, SP flooding, and conventional waterflooding in NFRs. Sensitivity analysis was performed to study the impact of treatment parameters on the oil recovery from naturally fractured reservoirs. Using actual NFR data, the optimum VES flooding was determined, which will help in conducting VES flooding for real EOR operations.

Assessment of Oral Health-Related Quality of Life and Its Associated Factors among the Young Adults of Saudi Arabia: A Multicenter Study.

Oral health-related quality of life (OHRQoL) is an essential indicator of people's overall health and health-related quality of life. Poor oral health and OHRQoL among young adults lead to numerous negative consequences and an increased burden on the healthcare system. The present study is aimed at assessing the OHRQoL among the young adults of Saudi Arabia, identifying self-rated oral health, and determining the relationship between sociodemographic and lifestyle factors with the OHRQoL. The present analytical cross-sectional survey was conducted among 1152 health and non-health-related college university students from three randomly selected universities. The OHRQoL was evaluated using the validated Arabic version of the oral health impact profile-14 questionnaire (OHIP-14). Of the population studied, one-fourth of the participants (24.9%) reported poor or fair oral health, and the highest OHIP-14 score was found in the domains of physical pain (4.14), followed by psychological discomfort (4.07). Logistic regression analysis revealed that the poor oral health category was significantly associated with male gender (ref: female: adjusted OR (AOR) = 1.89, 95%CI = 1.23-2.94, p = 0.004), daily smokers (ref: nonsmokers: AOR = 3.47, 95%CI = 1.97-4.82, p < 0.001), chocolate and candies intake more than once a day (ref: never; AOR = 1.54, 95%CI = 1.10-2.19, p = 0.034), and did not seek periodical dental care (ref: periodic dental care received: AOR = 2.23, 95%CI = 1.53-2.86, p = 0.002). The present study revealed the factors associated with poor OHRQoL. The concerned authorities should consider the implementation of periodic dental checkups for university students, especially for the high-risk group. Furthermore, it is recommended to have regular health education programs that will help to change the student's lifestyle and poor oral health behaviors.

Prevalence and risk factors profile of seropositive Toxoplasmosis gondii infection among apparently immunocompetent Sudanese women.

OBJECTIVES: Toxoplasma gondii is an opportunistic parasite that causes a clinical manifestation known as toxoplasmosis. We investigated the prevalence and potential risk factors of T. gondii infection among women in Khartoum, Sudan. A sero-parasitological cross-sectional study included 100 women aging between 15 and 50 years old was conducted between January and November 2018. Serum samples were collected and investigated for the presence of anti-T. gondii immunoglobulins. RESULTS: Mean age of the women population included was 26.75 ± 8.25 with a range between 15 and 50 years. Sero-prevalence of T. gondii antibodies was 27% (27/100) with a 95% confidence interval (CI) of 18.6-36.8%. Among seropositive population 81% (22/27), 15% (4/27) and 4% (1/27) were seropositive for IgG antibodies, IgM antibodies and both antibodies respectively. Age group 21-30 years old had the highest frequency of detected IgG (10/45) and IgM (3/45). Married women had the highest frequency of detected IgG or IgM, 18/79 and 3/79, respectively. Risk factors analysis showed a total of 37/100 participants were having direct contact with cats and 66/100 have a frequent raw meat consumption, neither direct cats contact nor raw meat consumption had a statistically significant association with seropositivity to T. gondii (P value = 0.052 and 0.565, respectively).

Perspectives of interns and residents toward do-not-resuscitate policies in Saudi Arabia.

OBJECTIVE: Do-not-resuscitate (DNR) orders in Saudi Arabia were first regulated by a fatwa on a national level in 1988, one that excludes the patient and their families from decision making. Although the core of this policy is taken up by all hospitals in Saudi Arabia, there is no homogeneity in implementation. Here, we appraise what interns and residents know of these policies and their attitudes toward DNR. METHODS: Interns and residents in four major hospitals in Jeddah, King Abdulaziz University Hospital, National Guard Hospital, King Fahad General Hospital, and King Fahad Armed Forces Hospital, were given a questionnaire in English with four blocks of questions. RESULTS: A total of 140 questionnaires were included in our study. From these questionnaires, we conclude a lack of familiarity with DNR's policies and the fatwa and also a lack of understanding when it comes to treating DNR-labeled patients. The majority opinion was to include the patient in the decision-making process who is excluded according to the fatwa. Participants considered patients' dignity, religious concerns, and legal concerns to be important in considering resuscitation. CONCLUSION: We conclude a need to emphasize the issue of DNR and treatment of DNR patients in medical ethics classes in Saudi Arabia and put more effort to enact national DNR laws that include the patient in the decision-making process.

An effective combination of carbohydrases that enables reduction of dietary protein in broilers: importance of hemicellulase.

After observing the effects of purified cellulase (C), hemicellulase (H), pectinase (P), and their combinations on the in vitro digestibility of a corn-soybean meal broiler diet, we examined the associations between pectin breakdown and the digestibilities of CP and DM by using free galacturonic acid (GA) as an index of pectin breakdown. There was no significant effect of the single enzymes except for H. However, the enzyme combinations H + P, C + H, and C + H + P significantly increased CP and DM digestibilities, whereas the combination of C + P was not effective. Because H has activities of both H and P, these enzymes were considered to be important in stimulating digestion. Furthermore, when the enzymes increased CP and DM digestibilities, GA concentration was significantly higher, and clear correlations between CP and DM digestibilities and GA concentration were observed, whereas correlations between the digestibilities and concentration of glucose or xylose + mannose as indices of cellulose and hemicellulose breakdown, respectively, were not significant. From these observations, we hypothesized that a mixture of enzymes could increase the protein digestibility of broiler feed. Thus, in the in vivo experiment, low-protein (19% CP) diets made mainly of corn and soybean meal with or without mixed enzymes were prepared and given to broiler chicks. The birds given the diet containing mixed enzymes showed significantly higher BW gain, with higher CP and DM digestibilities than the birds given the diet without the mixed enzymes. Moreover, the growth rate was same as that of the birds given the normal (21% CP) diet. The results indicate that the mixed enzyme preparation can effectively degrade indigestible cell constituents and thus enable the protein of the broiler feed to become more digestible. Furthermore, the results indicate the importance of H as a rate-limiting factor of cell wall breakdown.

Effect of alkaline hydrogen peroxide treatment on cell wall composition and digestion kinetics of sugarcane residues and wheat straw.

Our objective was to characterize changes in cell wall composition and digestibility of sugarcane bagasse, pith from bagasse, and wheat straw after treatment with alkaline hydrogen peroxide (AHP). The AHP treatment solution contained 1% H2O2 (wt/vol) maintained at pH 11.5 with NaOH. The H2O2 in solution amounted to 25% of the quantity of substrate treated. After treatment, residues were washed and dried. Detergent fiber composition, total fiber components (neutral sugars, uronic acids, Klason lignin, and noncore lignin phenolic acids), IVDMD, in vitro digestion kinetics of NDF, and monosaccharide digestibilities (24 and 120 h) were determined. Total fiber (TF) and NDF concentrations of all treatment residues were increased (P less than .05) over control substrates by AHP because of greater losses of cell solubles than of cell wall constituents. Hemicellulose:cellulose ratio in NDF of treatment residues was decreased (P less than .05) by AHP for all substrates, but the neutral sugar composition of TF did not agree with this preferential loss of hemicellulose components. Klason lignin, ADL, and esterified noncore lignin, especially ferulic acid, were reduced (P less than .05) by AHP, whereas etherified noncore lignin composition was unchanged. Treatment increased (P less than .05) IVDMD, extent of NDF digestion, and monosaccharide digestibilities of all crop residues. The rate of NDF digestion was increased (P less than .05) for the sugarcane residues but not for wheat straw. Alkaline hydrogen peroxide improved crop residue digestibility, probably as a result of the removal of core and noncore lignin fractions.